title: Neonatal hypotension: dopamine or dobutamine?
abstract: Controversy surrounds the assessment of perfusion and the methods currently utilised to define hypotension, especially blood pressure. There is growing agreement to assess heart function when selecting inotropic therapy and use bedside tools such as echocardiography for assessing at-risk infants. Both dopamine and dobutamine have comparative efficacy, and in certain disease states with immature myocardium there could be potential advantages in using dobutamine. The concomitant use of hydrocortisone has been shown to be beneficial when escalating doses of first-line inotropes are used. Other inotropes require further study through randomised trials for their safety and efficacy to be established.
authors.affiliation: Department of Paediatrics, University Hospital of North Tees and University of Durham, Stockton-on-Tees, UK. Electronic address: Samir.gupta@nth.nhs.uk.
authors.forename: Samir
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Donn
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004280:Dobutamine / Q000008:administration & dosage*; D004298:Dopamine / Q000008:administration & dosage*; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine; D004298:Dopamine
keywords: Circulation; Dobutamine; Dopamine; Hypotension; Inotrope; Newborn